Organization
RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC
Active
Other names
Santa Rosa Indian Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM THOMSEN (CEO)
(909) 864-1097
Entity
Organization
Contact information
Practice address
65175 ST. HIGHWAY 74, MOUNTAIN CENTER, CA 92561-9231
(951) 823-8882
(951) 225-6879
Mailing address
11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5172
(909) 864-1097
(951) 225-6879
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/23/2021
Last updated
09/16/2021
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